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What are the signs and symptoms of increased intraocular pressure? T. R. Carscadden, MD, Lively, ON

Patients often present to their eye care specialist with symptoms of pressure in and around their eye(s). An oft-asked question is whether their intraocular pressure (IOP) may be elevated, and whether they might be at risk for glaucoma. The fact is that elevations in IOP almost never cause perceivable symptoms for patients, unless the rise in pressure is severe and very rapid. In these quite rare cases, the clinical presentation is often dramatic. In angle-closure glaucoma for instance, patients not only present with severe pain and pressure symptoms in their eye, but also with vision loss, nausea and general malaise.

But most patients presenting to their ophthalmologists with elevated IOP are unaware of the problem. This raises a serious concern with regard to glaucoma screening, as many patients don’t attend regular primary eye care appointments unless they develop a vision problem. Elevated IOP can cause progressive glaucomatous damage to the optic nerve that may go undetected by the patient until the very late stages of irreversible visual loss. This is a major reason why patients are encouraged to attend regular eye examinations at least every two years.